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患者女,44岁,发现颈部肿块3年、胸闷气促1月于1993年2月9日入院.3年前偶然发现颈部肿块,但无心悸、出汗、消瘦、纳亢,情绪稳定,曾来本院检查吸~(131)碘率、T_3、T_4,均正常,可胜任日常工作,故未治疗.1月前自觉受凉后咳嗽,活动后气急,胸闷,无发热,痰较少.本院门诊考虑上感、支气管哮喘,经对症处理症状无好转,今上班途中骑车时因气急加重晕倒在地,急诊来院,拟支气管哮喘、甲状腺腺瘤收住入院.平素体健,无支气管哮喘史,家族中无类似甲状腺疾病史.体检:神清,呼吸略促,无紫绀,锁骨上颈部无淋巴结触及,无突眼,甲状腺Ⅲ度均匀性肿大,右侧大于左侧,质地较硬,无压痛及血管杂音.喉间有痰鸣音、两肺可闻稀疏哮鸣音,心脏听诊正常.腹软.胸片:两肺未见明显实质性病变.B超:双侧甲状腺肿大,右侧甲状腺腺瘤.CT检查:甲状腺腺瘤,气管向左推移,且变形,未见异常钙化影和低密度影.无明显淋巴结影、甲状腺功能测定:T_3 1.3nmol/L,T_4 94nmol/L,γT_3 0.5nmol/L,TSH
Female, 44 years old, found that the neck mass 3 years, chest tightness and shortness of breath January was admitted to hospital on February 9, 1993. 3 years ago, accidentally found neck mass, but no heart palpitations, sweating, weight loss, hyperactivity, emotional stability , Had to our hospital to check the suction ~ (131) iodine rate, T_3, T_4, are normal, capable of daily work, it is not treated .1 months ago consciously cough after cold, shortness of breath, chest tightness, Hospital outpatient consider the flu, bronchial asthma, symptomatic treatment of symptoms did not improve, this way to work on the road due to aggravated fainting to the ground, emergency hospital, to be bronchial asthma, thyroid adenoma admitted to hospital .Physiological health, No history of bronchial asthma, family history of similar thyroid disease. Physical examination: Shen Qing, breathing a little faster, no cyanosis, no lymph nodes on the supraclavicular touch, no exophthalmos, thyroid Ⅲ degree uniform enlargement, right than the left , Hard texture, no tenderness and vascular murmur.He had sputum beating sound in the throat, sparse wheeze in both lungs, auscultation in the heart, abdomen softness, chest radiograph, no obvious substantive lesion in both lungs.B super: double Side of the goiter, right thyroid adenoma.CT examination: thyroid adenoma, trachea to the left, and deformation, no abnormal calcification . Movies low density no lymph node, thyroid function test: T_3 1.3nmol / L, T_4 94nmol / L, γT_3 0.5nmol / L, TSH